[Preoperative evaluation of hemorrhagic risk]

Area of Science:

• Clinical pathology
• Anesthesiology
• Transfusion medicine

Context:

• Unexpected intraoperative bleeding poses significant challenges for anesthesiologists.
• Traditional laboratory-based haemostasis tests often lack the speed required for emergency surgical situations.
• Timely therapeutic decisions are critical to manage patient bleeding effectively.

Purpose:

• To evaluate the utility of rapid, point-of-care haemostasis testing in guiding intraoperative therapeutic choices.
• To highlight the need for devices capable of performing comprehensive haemostasis tests at the surgical site.
• To define the complementary roles of point-of-care testing and central laboratory analysis.

Summary:

• Rapid haemostasis tests performed near the operating room enable anesthesiologists to make prompt decisions regarding transfusion policies.
• These point-of-care devices should offer more than basic tests, including platelet counts and haematocrit, to assess haemostasis function.
• Centralized laboratory testing remains essential for detailed coagulation profiling and quality assurance of point-of-care results.

Impact:

• Improved patient management during unexpected surgical bleeding through timely, informed therapeutic interventions.
• Enhanced efficiency in operating rooms by reducing delays associated with conventional laboratory test turnaround times.
• Optimized transfusion strategies based on rapid, accurate haemostasis data, potentially reducing unnecessary blood product usage.